This section provides background information related to the present disclosure which is not necessarily prior art. This section also provides a general summary of the disclosure, and is not a comprehensive disclosure of its full scope or all of its features.
The opportunity for this new unique type of clinical decision support system has been brought about by the expansion of the electronic medical record. Historically, physiology data have all been displayed in electronic fashion and, in some cases, at least some of the data can be stored. More recently, the patients' medical history data are being collected in an electronic format. Some of those data collection systems supply those data in a structured format (relational database) that allows fields to be queried. Additionally, over the past decade, anesthesia intraoperative records have become available in electronic format. Initial efforts in producing an electronic anesthesia information system (known as AIMS) started in the 1980s; the technology was not mature and not widely adopted until relatively recently. Currently, there is a minimum of eight or more systems being marketed around the world.
In the perioperative and acute care ICU environment, these data are now available in real-time. The impetus for the present teachings is the incorporation of all these data to display information in a readily useable, real-time, updated fashion that extracts data from the medical history, the current medical management, known medical systems currently operable in connection with the patient, known therapies, including medications, currently impacting the patient, and the current physiologic monitors to produce warnings, alerts, signals, reminders, recommendations, or instructions to enable caregivers to be made aware of physiologic systems at risk, (physiologic systems in normal range, borderline normal range, and abnormal range of function). The present teachings also provide other intelligent indicia determined, gathered, calculated, or otherwise ascertain to provide warnings, alerts, signals, reminders, recommendations, or instructions to a caregiver in light of a plurality of data and known factors. That is, these data are not only presented, but also use real-time queries and calculations to enable caregivers to have the types of data that would traditionally assist them in patient care but only be available by reviewing the medical literature and/or doing retrospective individual calculations while providing patient care.
It should be appreciated that the principles of the present teachings enable additional factors, such as devices or implantables that interact with various organs within the patient body, to be actively monitored and considered in determining patient care. In many cases, these devices are not just passive monitoring physiologic signals, but are also actively interacting with the body or other biological system of the patient. For example, a cardiac bypass machine actively pumps blood through the cardiovascular system when the heart is stopped during specific operations. There are situations where the presence of such a device or implantable may not be readily apparent to caregivers; for example, a pacemaker could be implanted within a patient without its presence being immediately known.
It should also be appreciated that the principles of the present teachings enable additional factors, such as drugs or therapeutics that interact with various organs within the patient body to be actively monitored and considered in determining patient care. In many cases, these drugs are interacting with the body or other biological system of the patient. Current display devices typically just communicate when a drug was administered, alert if a dose was forgotten or if there are potential counter-indications, such as allergies, or indicate that a drug is part of a regimen this patient is currently self-administering. There are situations where the impact of a drug on a specific organ system may not be readily apparent or where the impact of the drug on the patient body or biological system may not be clearly understood when employing conventional systems.
Unfortunately, current display devices do not provide context as to the status of these devices or implantables. It should be appreciated that information relating to whether these medical devices or implantables are malfunctioning, turned off, or in some other non-functioning state could provide useful information in patient diagnosis and treatment. But, often times, that information is not readily apparent, nor is it displayed alongside the display device that shows the monitoring signal from the organ or organ systems that is monitoring the patient.
Moreover, in the current practice of medicine there exists a large body of information, including clinical references, protocols, and guidelines that help to aid a caregiver in the treatment of patients. However, due to the breadth of such information, it can be difficult to quickly obtain such information during time-sensitive periods of patient treatment. The present teachings enable automated access to clinical documentation during treatment through on-screen alerts, reminders, and links to clinical references, protocols, and guidelines.
According to the principles of the present teachings, in some embodiments, the display system can comprise several general concepts. First, the display can have readily identifiable icons for each of the vital organs—brain, lung, heart, kidneys, liver, skin, and the body—and also related medical systems—mechanical ventilators, pacemakers, and the like. Second, these readily identifiable icons can move in real-time with the input of real-time physiologic data and medical system operational conditions. For example, the heart beats in real-time with the patient's heartbeat provided by the physiologic monitor and the lungs expand and retract (ventilate) in real-time with the physiologic data provided from the monitoring system and anesthesia machine (airway pressures). Third, the icons can be color coded to signify the parameters are in various ranges, such as a normal range being depicted in the color green, a marginal range being depicted in the color yellow, and an abnormal range being depicted in the color red.
In some embodiments, the icons can be color-coded orange (or any other indicia) if that organ system is at risk, given that patient's individual history that is associated with a specific risk for that organ. For example, if the patient has significant risk factors for postoperative myocardial infarction (heart attack) the rim around the heart can be the color orange alerting the caregiver that this patient is at risk.
Finally, in some embodiments, the display system of the present teachings can provide pop-up alerts, or other alerts, when a combination of events occurs which produces a situation where there could be a possible important physiologic or medical system abnormality that could potentially cause risk or harm to the patient.
The color coding risk analysis and pop-up alerts will be described below under the specific organ system sections. However, it should be appreciated that variations can be made to the color, indicia, or other alert protocol without departing from the scope of the present teachings.
Further areas of applicability will become apparent from the description provided herein. The description and specific examples in this summary are intended for purposes of illustration only and are not intended to limit the scope of the present disclosure.
Corresponding reference numerals indicate corresponding parts throughout the several views of the drawings.